Everyone loves a summer holiday, but it can also throw up some challenges for our skin. Mosquito bites can be really frustrating both home and abroad, last year I spent a week in a fabulous villa, 5 bedrooms, his and hers bathrooms in the master suite, the living area was as big as my own homes ground and upstairs footage combined, indoor pool leading to an outdoor pool, it was fantastic, except for one thing mosquito bites, I have never experienced anything as bad as this before, and I can say it almost ruined my holiday, I had to drink more Jack Daniels than usual to stop feeling sorry for myself. By the end of the week my forehead looked like Worf (Star Trek Next Generation).

Clothing colour
Mosquitoes are attracted to dark colours such as black and navy blue, as they use vision along with scent to locate their targets. It is best to dress in light colours such as white or pastels to reduce the risk of this.

This is probably the most effective way of reducing the risk of mosquito bites or insect bites in general.

Chemical-based
Diethyltouamide (DEET) is probably the most effective chemical repellent available and has a good safety record. Research has shown that a repellent containing approximately 20% DEET will protect the wearer for about 5 hours. It has a good safety record and weaker formulations of 10% or less are safe to use on infants from the age of 2 months.

Other chemical agents available include icaridin and IR3535. They differ slightly in their effectiveness and characteristics but all work in the same way, producing an odour that is unpleasant to mosquitoes

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Plant-based
There are a number of plant based chemicals that can offer some protection against mosquito bites.They are not as effective as DEET and are not recommended as the only protection in areas that are endemic to malaria. These include citronella, lemon eucalyptus, and neem to name a few.

Minimising discomfort from insect bites

Insect bites can commonly cause lumps (papules), itching (pruritus), and whealing (urticarial) of the skin. Occasionally, small blisters (bullae) may develop. There are a number of things that can be done to minimise discomfort.

Antihistamines – taking oral antihistamines will relieve the itch and swelling e.g. cetirizine 10mg once or twice a day.

Mild steroid cream – hydrocortisone 0.5-2.5% applied twice daily for a few days can reduce inflammation and itching

Calamine lotion to affected areas

Cooling the skin e.g. with a cold compress

The bites should usually settle within a few hours to a few days. It is important to avoid scratching the skin as this increases vulnerability to developing infection at the site of the bite. One of the many functions of skin is to act as a barrier to the outside world. If the skin becomes broken e.g. as a result of scratching, infection is much more likely to develop.

If you notice pus or discharge in or around the bite, increased pain, redness or swelling, or swollen glands, then suspect infection. This may require treatment with oral antibiotics (usually flucloxacillin unless there is an allergy to penicillin) so attend your local doctor.lisa@britishskinfoundation.org.uk